Abstract
Disruption of the knee extensor mechanism is a challenging injury with no clear consensus
on optimal treatment. Although rare in the setting of knee dislocations, these injuries
should not be overlooked. Acute, complete rupture of either the quadriceps or patellar
tendon necessitates primary repair with or without augmentation. Surgical management
may also be required in the setting of a partial tear if a significant extensor lag
is present or nonoperative treatment has failed. Tendon augmentation is used during
primary repair if the native tissue is inadequate or after a failed primary repair.
The purpose of this study is to evaluate extensor mechanism disruption incidence,
injury patterns, associated injuries, and surgical options, including a novel tendon
augmentation technique. This procedure consists of primary patellar or quadriceps
tendon repair with semitendinosus autograft augmentation utilizing a distal or proximal
patellar socket. Advantages of repair with tendon augmentation include accelerated
rehabilitation, decreased risk of patellar fracture from transverse or longitudinal
bone tunnels, and less hardware complications. We recommend consideration of this
technique for selected cases of acute extensor mechanism disruption in the setting
of tibiofemoral dislocation.
Keywords
extensor mechanism disruption - knee dislocation
